Provider Demographics
NPI:1558810804
Name:SPIRKO, MICHELE ANN (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:SPIRKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:ANN
Other - Last Name:READING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 RESEARCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2178
Mailing Address - Country:US
Mailing Address - Phone:413-549-8400
Mailing Address - Fax:413-549-8409
Practice Address - Street 1:17 RESEARCH DRIVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2178
Practice Address - Country:US
Practice Address - Phone:413-549-8400
Practice Address - Fax:413-549-8409
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110153756AMedicaid